Mental Health Chapter 21 Evolve Questions (Impulse Control Disorders)

Which child is demonstrating behaviors that support a diagnosis of adolescent onset conduct disorder? a. A 12-year-old male who steals a bicycle as a gang initiation b. A 9-year-old male who smokes half a pack of cigarettes a day c. A 12-year-old female who regularly bullies her younger siblings d. A 9-year-old female who engages in sexually provocative behaviors

a. A 12-year-old male who steals a bicycle as a gang initiation In adolescent-onset conduct disorder, no symptoms are present prior to age 10. Affected adolescents tend to act out misconduct with their peer group (e.g., early onset of sexual behavior, substance abuse, risk-taking behaviors). Males are more likely to fight, steal, vandalize, and have school discipline problems, whereas girls tend to lie, be truant, run away, abuse substances, and engage in prostitution.

Which of the following classifications of medication may be prescribed in intermittent explosive disorder? a. Anticonvulsants b. Psychostimulants c. Antianxiety agents such as benzodiazepines d. Monoamine oxidase (MAO) inhibitors

a. Anticonvulsants Although considered off-label use, anticonvulsants may reduce outbursts and contribute to mood stabilization. The other options are incorrect for use in intermittent explosive disorder.

As an adult, a client who has been diagnosed with childhood-onset conduct disorder is at high risk for developing which comorbid disorder? a. Antipersonality disorder b. Obsessive-compulsive disorder c. Kleptomania d. Depression

a. Antipersonality disorder Individuals with childhood-onset conduct disorder are more likely to have problems that persist through adolescence, and without intensive treatment, they develop antisocial personality disorder as adults. Research does not support any of the other options.

The nurse is preparing to set goals for a 10-year-old diagnosed with an impulse control disorder. To best ensure the expected therapeutic outcomes, the nurse includes goals that focus on what client need? a. Client centered and includes the client's input b. Age appropriate and achievable in a short period of time c. Simple and easily defined d. Family centered and long term in nature

a. Client centered and includes the client's input Whenever possible, outcomes should be client centered and agreed upon by both the nurse and the client or the client's designee. While the other options may be appropriate, they are not the priority.

A client diagnosed with conduct disorder craves what experience? a. Excitement without concern for possible negative outcomes b. Control of situations and constantly strategizes for such power c. Friendship but from those older than themselves d. Material possessions but lacks focus and direction

a. Excitement without concern for possible negative outcomes People with conduct disorder crave excitement and do not worry as much about consequences as other people do. None of the other options demonstrates a need associated with conduct disorder.

Which of the following statements are true regarding childhood-onset conduct disorder? (Select all that apply.) a. It is more commonly diagnosed in males. b. It is characterized by feelings of remorse and regret. c. It is usually diagnosed in late teen years. d. It is characterized by disregard for the rights of others. e. Those with conduct disorder rationalize their aggressive behaviors. f. It is usually outgrown by early adulthood.

a. It is more commonly diagnosed in males. d. It is characterized by disregard for the rights of others. e. Those with conduct disorder rationalize their aggressive behaviors. Childhood-onset conduct disorder is more common in male patients and is seen before the age of 10 years. Hallmarks include disregard for the rights of others, physical aggression, poor peer relationships, and lack of feelings of guilt or remorse. The other options are the opposite of what is correct.

When working with a client demonstrating impulse control disorders, which nursing interventions have initial priority? (Select all that apply.) a. Providing a safe environment b. Establishing a therapeutic nurse-client relationship c. Setting and enforcing limits d. Confronting the client concerning the disruptive behavior e. Presenting appropriate expectations

a. Providing a safe environment b. Establishing a therapeutic nurse-client relationship c. Setting and enforcing limits e. Presenting appropriate expectations The most important interventions with this population are to promote a climate of safety for the patient and for others, establish rapport with the patient, and set limits and expectations. Confronting behaviors is not an initial priority.

Pyromania, a behavior associated with impulse control disorders, causes an individual to engage in what behavior? a. Starting fires b. Stealing for thrill c. Self-mutilate d. Directing anger toward others

a. Starting fires Pyromania is described as repeated, deliberate fire setting. This behavior does not include any of the other stated options.

Which comorbid conditions are commonly associated with oppositional defiant disorder? (Select all that apply.) a. Conversion disorder b. Attention deficit hyperactivity disorder (ADHD) c. Depression d. Anxiety e. Substance abuse

b. Attention deficit hyperactivity disorder (ADHD) c. Depression d. Anxiety Oppositional defiant disorder is related to a variety of other problems, including attention deficit hyperactivity disorder, anxiety, and depression. Neither of the remaining options are closely associated with this diagnosis.

The mother of a 6-year-old child expresses concern over the child's frequent temper outbursts. He deals with any frustration by bullying and hitting and seldom shows any remorse for his actions. The nurse who gathers this data will note that the child's behaviors are most consistent with which diagnosis? a. Social phobia b. Conduct disorder c. Oppositional defiant disorder d. Attention deficit hyperactivity disorder (ADHD)

b. Conduct disorder The data are most consistent with the aggressive pattern of childhood-onset conduct disorder of the aggressive type.

Which nursing intervention is appropriate for the management of intermittent explosive disorder? a. Providing intensive family therapy b. Establishing a trusting relationship with the patient c. Setting up loose boundaries so the patient will feel relaxed d. Limiting decision-making opportunities to avoid frustration

b. Establishing a trusting relationship with the patient Establishing rapport with the patient is essential in working to set goals, boundaries, and consequences, and providing opportunities for goal achievement. Intensive family therapy would not be a basic level RN intervention. Boundaries and structure are essential. Opportunities for patients to make good decisions and reach goals should be given, not limited.

A 17-year-old patient is admitted to the psychiatric unit after threatening his mother during an argument and is diagnosed with conduct disorder. Which of the following would be an appropriate short-term outcome for this patient? a. Engages in appropriate coping skills to manage stressors b. Expresses feelings c. Maintains self-control during hospitalization d. Mother will improve communication skills to interact with Eli.

b. Expresses feelings Expressing feelings is an appropriate short-term outcome and would be a good start to working with the patient to establish rapport, develop coping skills, and set goals. Engaging in appropriate coping skills and maintaining self-control are desired outcomes. Outcomes for the patient are being discussed, not outcomes for the patient's mother.

When treating impulse control disorders, psychodynamic psychotherapy is directed toward which goal? a. Mastering relaxation techniques b. Identifying the triggers of the rage c. Teaching the client self-distracting techniques d. Helping the client replace the rage with acceptable alternative feelings

b. Identifying the triggers of the rage Psychodynamic psychotherapy focuses on underlying feelings and motivations and explores conscious and unconscious thought processes. In working with impulse control problems, the therapist may help the patient to uncover underlying feelings and reasons behind rage or anger. This may help them to develop better ways to think about and control their behavior. None of the other options are considered goals of this form of therapy.

Which statement is true about the characteristics of the oppositional defiant child? a. The defiance is generally directed toward parents and siblings. b. These behaviors are a predictor of future mental health disorders. c. Arguing tends to be more prevalent in boys. d. Girls display more blaming than do boys.

b. These behaviors are a predictor of future mental health disorders. Oppositional defiant disorder is often predictive of emotional disorders in young adulthood. None of the other statements are necessarily correct.

Assessment for oppositional defiant disorder should include which interventions? a. Assessing the history, frequency, and triggers for violent outbursts b. Assessing moral development, belief system, and spirituality for the ability to understand the impact of hurtful behavior on others, to empathize with others, and to feel remorse c. Assessing issues that result in power struggles and triggers for outbursts d. Assessing sibling birth order to understand the dynamics of family interaction

c. Assessing issues that result in power struggles and triggers for outbursts Oppositional defiant disorder is characterized by defiant behavior, power struggles, outbursts, and arguing with adults, so assessment of these factors would be important. Assessing for violent outbursts refers to assessment for intermittent explosive disorder. Oppositional defiant disorder is not characterized by violent behaviors. Assessing for the ability to understand the impact of hurtful behaviors on others refers to assessment for conduct disorder. Birth order is not known to play a part in oppositional defiant disorder.

When parents share that their 8-year-old child seems to "always try to be annoying and hateful," the nurse suspects the child is demonstrating which characteristic? a. Emotionally immature b. Anxiety c. Vindictiveness d. Depression

c. Vindictiveness Vindictiveness is defined as spiteful, malicious behavior. The person with this disorder also shows a pattern of deliberately annoying people and blaming others for his or her mistakes or misbehavior. This child may frequently be heard to say "He made me do it!" or "It's not my fault!" The description is not associated with any of the other options.

Which behavior consistently demonstrated by a child is a predictor of future antisocial personality disorder in adults? a. Sadness b. Remorse c. Guilt d. Callousness

d. Callousness Callousness may be a predictor of future antisocial personality disorder in adults. The remaining options would indicate a degree of empathy not observed in a client who is demonstrating antisocial tendencies.

A poorly developed sense of empathy is thought to be the result of having what life experience? a. A family history of mental illness b. a low serum testosterone level c. suffered head trauma at an early age d. unmet physical and emotional needs

d. unmet physical and emotional needs A history of not having one's own needs met may indicate an individual who has a less well-developed sense of empathy. Research does not support any of the other options.